What Happens During a Frenectomy?

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Tongue-ties, buccal ties, and lip ties are congenital conditions that can restrict the movement of the tongue or upper lip. It occurs when the frenulum is short or restrictive and connected at a non-ideal location. This can cause a number of problems as a child grows and develops.

The short frenulum of the tongue keeps the tongue anchored to the area under the tongue or behind the lower front teeth. This can cause problems for a person, such as eating/feeding inclusive of breastfeeding and solids, airway, sleep, tension, migraines, and, speaking. The short frenulum of the lip keeps the lip close to the gums and can keep new teeth from erupting correctly.

The way to correct these types of problems is for the person to have a frenectomy and some oromotor therapy.

What is a frenectomy?

A frenectomy is an oral surgical procedure that is used to treat tongue-tie and lip tie and provide more range of motion.

A human has many frena in their mouth. Nine times out of ten, there are no issues involved with this. However, there are some people who have trouble with a frenum that is too tight or too short. This condition is called tongue tie if it involves the frenum of the tongue, and lip tie if the lips are involved.

During the frenectomy, the doctor cuts or removes the connective tissue, increasing the range of motion for that area.

Why would a person need a frenectomy?

Frenectomies are most commonly performed on infants, babies, or children who are having problems with nursing or feeding, or if there are concerns about their speech. However, adults can also benefit from the surgery. For instance, if an adult has a frenum that is so tight in their upper lip that it pulls at the gums, separating them from the teeth, or if it pulls the gums away from the teeth exposing the roots then they would definitely benefit from the surgery.

A dentist may recommend a frenectomy if the frenum is so tight in a person’s mouth that it is causing:

• Limited range of motion of the tongue or lips 
• Tension
• Gum recession
• Diastema (gap between the teeth)
• Pain, tenderness, or swelling with oral care such as brushing
• Oral Cleaning (having to use fingers to pick food out folds in the mouth)
• Increased cavity risk on teeth closer to the folds
• High Palate
• Mouth breathing and obstructive sleep apnea

This list does not include why a therapist or other providers may recommend the procedure be completed. Therapists may make a recommendation when issues are noted with feeding (texture struggles, picky eaters, choking when eating), speech (pronunciation and articulation, fatigue when speaking)and so much more. 

If the patient is experiencing any of these problems due to a short frenum, then the doctor may recommend that a frenectomy be completed to improve both comfort and function.

What are the types of frenectomies?

Frenectomies are a fairly common procedure, but there are different types and tools may vary. Each one addresses a certain area of the mouth where the problem is.

• Lingual Frenectomy – This is to correct tongue tie. During the procedure, the band of connective tissue between the floor of the mouth and the underside of the tongue is clipped or removed.
• Labial Frenectomy – This is to correct lip tie. During the procedure, the band of connective tissue between the upper lip and the upper gums at the front teeth is clipped or removed. This procedure can also be performed to correct a lip tie of the bottom lip, but that is not as common.
• Buccal Frenectomy –This is to relieve a tight and ill connected frenum from the cheek to the gums

The procedure is typically painless. Most of the time, the patient can return to their daily lives immediately with few, if any restrictions. It is often performed using a laser which further minimizes pain and the incidence of complications.

What are the disadvantages of a frenectomy?

While there are advantages of having a frenectomy, there is also the potential for some disadvantages. These can include:

• Discomfort and Pain – While the surgery itself is not typically painful, there can be some discomfort and pain during the recovery time. Some people report experiencing some muscle soreness the day after the procedure, but that is usually only within the first few days following the procedure. It is typically likened to a sore muscles the day after going to the gym
• Difficulty Swallowing Food – The soreness that may follow the surgery and sometimes lack of oromotor development/control can make it more difficult to swallow food and sometimes even liquid for a few days to a few weeks post-op.
• Uncontrolled Speech – Sometimes after a surgery for tongue tie, a person may have difficulty controlling their speech. This can happen in an older child or adult who has lived with the condition and has developed certain speech habits or compensations in an effort to cope. Once the procedure is done, it may take some time for the person to readjust their speech habits, allowing them more effective use of their tongue.
• Adhesions: If post operative care is not adequately completed, adhesions can form that are not ideal. Reattachment like some believe is unlikely especially if a laser is used. A 1-2 week follow up appointment is necessary to evaluate the sites and make sure healing is happening as expected. Care with a co-treatment team is also necessary. 

What are the benefits of a frenectomy?

There are several benefits of frenectomy surgery, based on the type the patient receives and the problems they were having before that prompted them to get the surgery.

• Improvement of speech issues that are caused by tongue tie
• Help the patient’s confidence and self-image and less recurring orthodontics by correcting getting rid of gaps in the teeth and improving their smile
• Improve an infant’s ability to effectively breastfeed
• Reduce the patient’s risk of oral health problems like gum disease and tooth decay
• Improved airway and breathing (can combine with SOLEA SLEEP if indicated)

What kind of providers help provide collaborative care?

Comprehensively assessing function, diagnosing, preparing and providing functional therapy after care is necessary to achieve optimal results post release. Specialists such as lactation consultants, speech therapists, myofucntional therapists, chiropractors, sleep doctors, primary care doctors and pediatricians are critical. One thing to note is that, as critical as these providers can be in identifying and treating tethered oral tissues (TOTs), not all of these have spent the time to learn about ties and their effects. Finding a savvy provider can be hard but Cusp Untethered has already done the work to find some of those providers. A list of providers can be found on our website under cotreatment team. 

Dentist in Virginia Beach

If you live in Virginia Beach or the surrounding area and need a dentist, you can do an internet search for “dentist near me” and take your chances, or you can call Cusp Untethered located in Cusp Dental Boutique and feel confident that you’ve made a sound choice for frenectomy and dental care.

The squad and dentist are ready to serve you and your family. Call today to make a reservation. We can’t wait to see you and see how we can help.

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